Valvular & structural heart disease
Phenotyping patients with a low-flow, low-gradient aortic stenosis and a preserved ejection fraction undergoing transcatheter aortic valve implantation
Authors' conclusion
One-third of TAVI patients with LF-LG aortic stenosis have an typical HFpEF/AF phenotype and a poor prognosis. They may benefit from guideline-directed HFpEF therapy, including SGLT-2 inhibitors and MRA.
Study context
- Population
- Patients with low flow, low-gradient (LF-LG) aortic stenosis and preserved ejection fraction undergoing transcatheter aortic valve implantation (TAVI) (UMCG, the Netherlands)patients undergoing TAVI, 216/628 patients with complete data had LF-LG preserved ejection fraction (pEF) · internal validation 405 · external validation (TUMunich, Germany) 173
- Participants
- 827 patients
- Comparison
- Cluster 1 versus cluster 2
- Cluster 1n = 77
- Cluster 2n = 139
- Outcome
- LF-LG pEF prevalence
Methodological detailsPrincipal component analysis, K-means clustering, internal and external validation
- Principal component analysis
- K-means clustering
- Internal and external validation
Performance
As reported in the abstract
Patients with complete data who had LF-LG pEF
216 of 628
34%
Mean age
78.8 (± 7.19) years
Female
57.9%
Further findings
| Outcome | Cluster 1 |
|---|---|
| Echocardiographic and clinical features | |
| H2FPEF score ≥6 | 49.4% |
| HFA-pEFF score ≥5 | 71.4% |
Echocardiographic and clinical features
- Cluster 1: larger left and right atrial dimensions, impaired left ventricular global longitudinal strain, reduced left atrial reservoir strain; older, higher rates of atrial fibrillation (AF) and heart failure (HF) versus cluster 2
Cardiovascular mortality and HF-hospitalization · 1- and 5-year
- Cluster 1 had higher risk, comparable to that of classical LF-LG patients
- Validation reproduced these results
Original publication
Phenotyping patients with a low-flow, low-gradient aortic stenosis and a preserved ejection fraction undergoing transcatheter aortic valve implantation. ESC Heart Fail. Published 31 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →